“The world [of minimally invasive cardiology] has been an explosion of advancements,” says Dr. Robert Welsh, cardiologist at the Mazankowski Alberta Heart Institute.

An estimated 1.6 million Canadians are either living with heart disease or at risk of stroke — combined they put more than 350,000 people in the hospital each year. Heart disease and stroke are the leading cause of death and hospitalization in Canada.

“In the past we had limited options — let’s say one therapy that worked for a group of patients — whereas now we may have multiple therapies,” Dr. Welsh says, adding that with more ways to treat they can provide healthcare solutions that better suit individual patients.

Advancing options

Minimally invasive techniques allow cardiologists to fix heart conditions from the inside. Repairing holes in the heart or addressing valve issues that used to require open-heart surgery, explains Dr. Welsh. Now these procedures can be done using a catheter inserted through a small needle in the groin. “It’s completely revolutionized how we work.”

"Minimally invasive procedures still have the same risks as major heart surgery, including the possibility of stroke or death, but the difference is what happens after the procedure has been completed."

Trans-catheter aortic valve implantation (TAVI) for example, is a procedure developed to replace aortic valves in the heart without having to open up a patient’s chest. The aortic valve allows blood to be pumped from the heart to the rest of the body. When the valve is unable to open properly — patients experience breathlessness, swollen ankles, chest pain, and even blackouts.

Though TAVI was developed as a last resort for higher risk patients who couldn’t have open-heart surgery, like the elderly or those dealing with other illnesses, it is now offered to a broader range of patients — enabling quicker recovery time and a better quality of life, explains Dr. Welsh.

Reducing recovery time

Dr. Michael Moon, a cardiothoracic surgeon at the Mazankowski Alberta Heart Institute, has seen the difference that minimally-invasive procedures make first hand.

Recently, Dr. Moon met a patient in his 80s with poor lung function due to a long history of smoking. The portion of the patient’s aorta that passes behind his lungs was dangerously enlarged and in need of surgery. However, the normal procedure would require surgeons to go between the patient’s ribs and replace the aorta by hand.

“There was no way this patient would be able to tolerate having an incision in his chest because of his poor lung function,” Dr. Moon says. Instead, the surgeon delivered a catheter based stent graft to repair the aorta from the inside.

Minimally invasive procedures still have the same risks as major heart surgery, including the possibility of stroke or death, but the difference is what happens after the procedure has been completed.

The patient came out of surgery with a two-inch incision in his groin instead of a 12-inch cut in his chest and will likely be discharged in less than a week. If he had done the surgical procedure, Dr. Moon says the patient may not have recovered at all.

These types of clinical advancements are not only beneficial for the patient, but meaningful for cardiologists as well.

“It’s gratifying to know that you can treat people that often have no option,” says Dr. Moon.